Use of HOMA-IR to diagnose non-alcoholic fatty liver disease: a population-based and inter-laboratory study
Open accessAbstract
Aims/hypothesis Recent European guidelines for non-alcoholic fatty liver disease (NAFLD) call for reference values for HOMA-IR. In this study, we aimed to determine: (1) the upper limit of normal HOMA-IR in two population-based cohorts; (2) the HOMA-IR corresponding to NAFLD; (3) the effect of sex and PNPLA3 genotype at rs738409 on HOMA-IR; and (4) inter-laboratory variations in HOMA-IR.Methods We identified healthy individuals in two population-based cohorts (FINRISK 2007 [n = 5024] and the Programme for Prevention of Type 2 Diabetes in Finland [FIN-D2D; n = 2849]) to define the upper 95th percentile of HOMA-IR. Non-obese individuals with normal fasting glucose levels, no excessive alcohol use, no known diseases and no use of any drugs were considered healthy. The optimal HOMA-IR cut-off for NAFLD (liver fat ≥5.56%, based on the Dallas Heart Study) was determined in 368 non-diabetic individuals (35% with NAFLD), whose liver fat was measured using proton magnetic resonance spectroscopy (1 H-MRS). Samples from ten individuals were simultaneously analysed for HOMA-IR in seven European laboratories.Results The upper 95th percentiles of HOMA-IR were 1.9 and 2.0 in healthy individuals in the FINRISK (n = 1167) and FIN-D2D (n = 459) cohorts. Sex or PNPLA3 genotype did not influence these values. The optimal HOMA-IR cut-off for NAFLD was 1.9 (sensitivity 87%, specificity 79%). A HOMA-IR of 2.0 corresponded to normal liver fat (<5.56% on 1 H-MRS) in linear regression analysis. The 2.0 HOMA-IR measured in Helsinki corresponded to 1.3, 1.6, 1.8, 1.8, 2.0 and 2.1 in six other laboratories. The inter-laboratory CV% of HOMA-IR was 25% due to inter-assay variation in insulin (25%) rather than glucose (5%) measurements.Conclusions/interpretation The upper limit of HOMA-IR in population-based cohorts closely corresponds to that of normal liver fat. Standardisation of insulin assays would be the first step towards definition of normal values for HOMA-IR.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Insulin resistance can also be measured clinically with the HOMA-IR index from fasting insulin or C-peptide and fasting glucose concentrations, including in people with T2D unless on insulin treatment.
“insulin resistance can also be measured clinically with the HOMA-IR index from fasting insulin or C-peptide and fasting glucose concentrations, including in people with T2D (unless on insulin treatment). 219 -221”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [220]
The Introduction defines HOMA-IR using fasting glucose and insulin and calls it a surrogate for insulin sensitivity in people without diabetes. It says HOMA-IR no longer exclusively reflects insulin sensitivity once glucose reaches the type 2 diabetes threshold; the Discussion likewise describes limitations in diabetic glucose tolerance. The cited passages do not support substituting C-peptide or establish insulin treatment as the only exception for people with T2D (page numbers unavailable). (LLM, conf=0.89)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Friedewald, W. T., Levy, R. I., & Fredrickson, D. S. (1972) · Clinical Chemistry · doi:10.1093/clinchem/18.6.499 · Cited by 32,423 · see citing works
Matthews, D. R., Hosker, J. P., Rudenski, A. S., Naylor, B. A., Treacher, D. F., & Turner, R. C. (1985) · Diabetologia · doi:10.1007/bf00280883 · Cited by 31,502 · see citing works
Toprak, Ö., Kurt, H., Sarı, Y., Şarkış, C., Us, H., & Kırık, A. (2017) · Kidney & Blood Pressure Research · doi:10.1159/000468530 · Cited by 29,769 · see citing works
Antihyperlipidemic and Biochemical Activities of Mcy Protein in Streptozotocin Induced Diabetic Rats
Marella, S., Maddirela, D. R., Badri, K. R., Kumar, M. V. J., & Chippada, A. R. (2015) · Cellular Physiology and Biochemistry · doi:10.1159/000373954 · Cited by 5,938 · see citing works
Use and Abuse of HOMA Modeling
Wallace, T. M., Levy, J. C., & Matthews, D. R. (2004) · Diabetes Care · doi:10.2337/diacare.27.6.1487 · Cited by 5,114 · see citing works
EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease
(2016) · Journal of Hepatology · doi:10.1016/j.jhep.2015.11.004 · Cited by 4,836 · see citing works
Prevalence of Hepatic Steatosis in An Urban Population in the United States: Impact of Ethnicity
Browning, J. D., Szczepaniak, L. S., Dobbins, R., Nuremberg, P., Horton, J. D., Cohen, J. C., Grundy, S. M., & Hobbs, H. H. (2004) · Hepatology · doi:10.1002/hep.20466 · Cited by 3,664 · see citing works
DeFronzo, R. A. (2009) · Diabetes · doi:10.2337/db09-9028 · Cited by 3,016 · see citing works
Nonalcoholic Fatty Liver Disease
Marchesini, G., Brizi, M., Bianchi, G., Tomassetti, S., Bugianesi, E., Lenzi, M., McCullough, A. J., Natale, S., Forlani, G., & Melchionda, N. (2001) · Diabetes · doi:10.2337/diabetes.50.8.1844 · Cited by 2,581 · see citing works
Bonora, E., Targher, G., Alberiche, M., Bonadonna, R. C., Saggiani, F., Zenere, M. B., Monauni, T., & Muggeo, M. (2000) · Diabetes Care · doi:10.2337/diacare.23.1.57 · Cited by 2,456 · see citing works
Pathogenesis of NIDDM. A balanced overview.
DeFronzo, R. A., Bonadonna, R. C., & Ferrannini, E. (1992) · Diabetes Care · doi:10.2337/diacare.15.3.318 · Cited by 2,085 · see citing works
Greiner, M., Pfeiffer, D., & Smith, R. D. (2000) · Preventive Veterinary Medicine · doi:10.1016/s0167-5877(00)00115-x · Cited by 1,923 · see citing works
Szczepaniak, L. S., Nurenberg, P., Leonard, D. S., Browning, J. D., Reingold, J. S., Grundy, S. M., Hobbs, H. H., & Dobbins, R. L. (2004) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00064.2004 · Cited by 1,562 · see citing works
Lillioja, S., Mott, D. M., Spraul, M., Ferraro, R., Foley, J. E., Ravussin, E., Knowler, W. C., Bennett, P. H., & Bogardus, C. (1993) · New England Journal of Medicine · doi:10.1056/nejm199312303292703 · Cited by 1,508 · see citing works
Non-alcoholic fatty liver disease as a cause and a consequence of metabolic syndrome
Yki‐Järvinen, H. (2014) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(14)70032-4 · Cited by 1,260 · see citing works
Sookoian, S. C., & Pirola, C. J. (2011) · Hepatology · doi:10.1002/hep.24283 · Cited by 917 · see citing works
Ferrannini, E., Natali, A., Bell, P., Cavallo-Perin, P., Lalic, N., & Mingrone, G. (1997) · Journal of Clinical Investigation · doi:10.1172/jci119628 · Cited by 898 · see citing works
Prevalence of insulin resistance in metabolic disorders: the Bruneck Study.
Bonora, E., Kiechl, S. J., Willeit, J., Oberhollenzer, F., Egger, G., Targher, G., Alberiche, M., Bonadonna, R. C., & Muggeo, M. (1998) · Diabetes · doi:10.2337/diabetes.47.10.1643 · Cited by 833 · see citing works
Prediction of Non-Alcoholic Fatty Liver Disease and Liver Fat Using Metabolic and Genetic Factors
Kotronen, A., Peltonen, M., Hakkarainen, A., Sevastianova, K., Bergholm, R., Johansson, L., Lundbom, N. M. I., Rissanen, A., Ridderstråle, M., Groop, L., et al. (2009) · Gastroenterology · doi:10.1053/j.gastro.2009.06.005 · Cited by 803 · see citing works
Bugianesi, E., Gastaldelli, A., Vanni, E., Gambino, R., Cassader, M., Baldi, S., Ponti, V., Pagano, G., Ferrannini, E., & Rizzetto, M. (2005) · Diabetologia · doi:10.1007/s00125-005-1682-x · Cited by 770 · see citing works
EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease
European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), & European Association for the Study of Obesity (EASO) (2016) · Diabetologia · doi:10.1007/s00125-016-3902-y · Cited by 685 · see citing works
Surrogate markers of insulin resistance: A review
Singh, B. (2010) · World Journal of Diabetes · doi:10.4239/wjd.v1.i2.36 · Cited by 622 · see citing works
Impaired Glucose Tolerance as a Disorder of Insulin Action
Lillioja, S., Mott, D. M., Howard, B. V., Bennett, P. H., Yki-Järvinen, H., Freymond, D., Nyomba, B. L., Zurlo, F., Swinburn, B., & Bogardus, C. (1988) · New England Journal of Medicine · doi:10.1056/nejm198805123181901 · Cited by 578 · see citing works
Thirty-five-year trends in cardiovascular risk factors in Finland
Vartiainen, E. A., Laatikainen, T. K., Peltonen, M., Juolevi, A., Männistö, S., Sundvall, J., Jousilahti, P., Salomaa, V. V., Valsta, L. M., & Puska, P. (2009) · International Journal of Epidemiology · doi:10.1093/ije/dyp330 · Cited by 500 · see citing works
Reference intervals: an update
Horn, P. S., & Pesce, A. J. (2003) · Clinica Chimica Acta · doi:10.1016/s0009-8981(03)00133-5 · Cited by 417 · see citing works
Sberna, A.-L., Bouillet, B., Rouland, A., Brindisi, M., Nguyen, A., Mouillot, T., Duvillard, L., Denimal, D., Loffroy, R., Vergès, B. L., et al. (2017) · Diabetic Medicine · doi:10.1111/dme.13565 · Cited by 322 · see citing works
Salgado, A. L. F. D. A., Carvalho, L. D., Oliveira, A. C., Santos, V. N. D., Vieira, J. G., & Parise, E. R. (2010) · Arquivos de Gastroenterologia · doi:10.1590/s0004-28032010000200009 · Cited by 315 · see citing works
Insulin Sensitivity and Its Measurement: Structural Commonalities among the Methods1
Radziuk, J. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.85.12.7025 · Cited by 289 · see citing works
Valenti, L. V. C., Alisi, A., Galmozzi, E., Bartuli, A., Menico, B. D., Alterio, A., Dongiovanni, P., Fargion, S. R., & Nobili, V. (2010) · Hepatology · doi:10.1002/hep.23823 · Cited by 288 · see citing works
Kotronen, A., Johansson, L. E., Johansson, L., Roos, C., Westerbacka, J., Hamsten, A., Bergholm, R., Arkkila, P., Arola, J. T., Kiviluoto, T. A., et al. (2009) · Diabetologia · doi:10.1007/s00125-009-1285-z · Cited by 288 · see citing works
The threshold value for insulin resistance (HOMA-IR) in an admixtured population
Geloneze, B., Repetto, E. M., Geloneze, S. R., Tambascia, M. A., & Ermetice, M. N. (2005) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2005.10.017 · Cited by 253 · see citing works
National type 2 diabetes prevention programme in Finland: FIN-D2D
Saaristo, T., Peltonen, M., Keinanen-Kiukaanniemi, S. M., Vanhala, M. J., Saltevo, J. T., NISKANEN, L. K., Oksa, H. H., Korpi-Hyövälti, E., & Tuomilehto, J. (2007) · International Journal of Circumpolar Health · doi:10.3402/ijch.v66i2.18239 · Cited by 210 · see citing works
Effect of liver fat on insulin clearance
Kotronen, A., Vehkavaara, S., Seppälä-Lindroos, A., Bergholm, R., & Yki-Järvinen, H. (2007) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00444.2007 · Cited by 202 · see citing works
Comparison of 11 Human Insulin Assays: Implications for Clinical Investigation and Research
Manley, S. E., STRATTON, I. M., CLARK, P. M. S., & Luzio, S. D. (2007) · Clinical Chemistry · doi:10.1373/clinchem.2006.077784 · Cited by 172 · see citing works
The Genetics of Nonalcoholic Fatty Liver Disease: Spotlight on PNPLA3 and TM6SF2
Day, C. P., & Anstee, Q. M. (2015) · Seminars in Liver Disease · doi:10.1055/s-0035-1562947 · Cited by 162 · see citing works
The 148M allele of the PNPLA3 gene is associated with indices of liver damage early in life
Romeo, S., Sentinelli, F., Cambuli, V. M., Incani, M., Congiu, T., Matta, V., Pilia, S., Huang‐Doran, I., Cossu, E., Loche, S., et al. (2010) · Journal of Hepatology · doi:10.1016/j.jhep.2010.02.034 · Cited by 160 · see citing works
Petäjä, E. M., & Yki‐Järvinen, H. (2016) · International Journal of Molecular Sciences · doi:10.3390/ijms17050633 · Cited by 144 · see citing works
Gastaldelli, A. (2011) · Diabetes Research and Clinical Practice · doi:10.1016/s0168-8227(11)70015-8 · Cited by 138 · see citing works
A population-based study on the prevalence of NASH using scores validated against liver histology
Hyysalo, J., Männistö, V., Zhou, Y., Arola, J., Kärjä, V. J., Leivonen, M., Juuti, A., Jaser, N., Lallukka, S., Käkelä, P., et al. (2013) · Journal of Hepatology · doi:10.1016/j.jhep.2013.12.009 · Cited by 127 · see citing works
Motamed, N., Hajimiresmaiel, S. J., Rabiee, B., Keyvani, H., Farahani, B., Maadi, M., & Zamani, F. (2015) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2015.11.019 · Cited by 75 · see citing works
Verrijken, A., Beckers, S., Francque, S., Hilden, H., Caron, S., Zegers, D., Ruppert, M., Hubens, G., Marck, E. V., Michielsen, P. P., et al. (2013) · Obesity · doi:10.1002/oby.20366 · Cited by 65 · see citing works
The threshold value for insulin resistance on homeostasis model assessment of insulin sensitivity
Nakai, Y., Fukushima, M., Nakaishi, S., Kishimoto, H., Seino, Y., Nagasaka, S., Sakai, M., & Taniguchi, A. (2002) · Diabetic Medicine · doi:10.1046/j.1464-5491.2002.00712_3.x · Cited by 58 · see citing works
Gutiérrez-Buey, G., Núñez-Córdoba, J. M., Llavero-Valero, M., Gargallo, J., Salvador, J., & Escalada, J. (2017) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2017.03.006 · Cited by 57 · see citing works
Männistö, S., Harald, K., Kontto, J. P., Lahti‐Koski, M., Kaartinen, N. E., Saarni, S. E., Kanerva, N., & Jousilahti, P. (2013) · British Journal Of Nutrition · doi:10.1017/s0007114513002742 · Cited by 55 · see citing works
Perez, M., Gonzáles, L. B., Olarte, R., Rodriguez, N. I., Tabares, M., Salazar, J. P., Jaimes, S. V., Garcia, R. G., & López-Jaramillo, P. A. (2010) · Preventive Medicine · doi:10.1016/j.ypmed.2010.11.021 · Cited by 44 · see citing works
Reference Values in Laboratory Medicine: The Current State of the Art.
Kirkwood, T., Gräsbeck, R., & Alström, T. (1982) · Biometrics · doi:10.2307/2529915 · Cited by 39 · see citing works
Preanalytical, Analytical, and Computational Factors Affect Homeostasis Model Assessment Estimates
Manley, S. E., Luzio, S. D., STRATTON, I. M., Wallace, T. M., & CLARK, P. M. S. (2008) · Diabetes Care · doi:10.2337/dc08-0097 · Cited by 39 · see citing works
Ben, M. D., Polimeni, L., Brancorsini, M., Costanzo, A. D., D’Erasmo, L., Baratta, F., Loffredo, L., Pastori, D., Pignatelli, P., Violi, F., et al. (2014) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2014.05.012 · Cited by 30 · see citing works
Reproducibility of HOMA and QUICKI among individuals with variable glucose tolerance
Borai, A., Livingstone, C., Anwar, F., Kholeif, M. A., Wang, T., & Ferns, G. A. (2010) · Diabetes & Metabolism · doi:10.1016/j.diabet.2010.01.006 · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Tacke, F., Horn, P., Wai-Sun Wong, V., Ratziu, V., Bugianesi, E., Francque, S., Zelber-Sagi, S., Valenti, L., Roden, M., Schick, F., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.031 · Cited by 2,210 · see citing works
Tanase, D. M., Gosav, E. M., Costea, C. F., Ciocoiu, M., Lacatusu, C. M., Maranduca, M. A., Ouatu, A., & Floria, M. (2020) · Journal of Diabetes Research · doi:10.1155/2020/3920196 · Cited by 627 · see citing works
(2024) · Obesity Facts · doi:10.1159/000539371 · Cited by 510 · see citing works
From NASH to diabetes and from diabetes to NASH: Mechanisms and treatment options
Gastaldelli, A., & Cusi, K. (2019) · JHEP Reports · doi:10.1016/j.jhepr.2019.07.002 · Cited by 455 · see citing works
Self-citationMuzurović, E. M., Mikhailidis, D. P., & Mantzoros, C. S. (2021) · Metabolism · doi:10.1016/j.metabol.2021.154770 · Cited by 339 · see citing works
Zelber-Sagi, S., Ivancovsky-Wajcman, D., Fliss Isakov, N., Webb, M., Orenstein, D., Shibolet, O., & Kariv, R. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2018.01.015 · Cited by 297 · see citing works
Measuring and estimating insulin resistance in clinical and research settings
Gastaldelli, A. (2022) · Obesity · doi:10.1002/oby.23503 · Cited by 244 · see citing works
Self-citationXue, Y., Xu, J., Li, M., & Gao, Y. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.951689 · Cited by 211 · see citing works
Mechanisms in bariatric surgery: Gut hormones, diabetes resolution, and weight loss
Holst, J. J., Madsbad, S., Bojsen-Møller, K. N., Svane, M. S., Jørgensen, N. B., Dirksen, C., & Martinussen, C. (2018) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2018.03.003 · Cited by 203 · see citing works
Lee, S. B., Kim, M. K., Kang, S., Park, K., Kim, J. H., Baik, S. J., Nam, J. S., Ahn, C. W., & Park, J. S. (2019) · Endocrinology and Metabolism · doi:10.3803/enm.2019.34.2.179 · Cited by 162 · see citing works
The Liver–α-Cell Axis and Type 2 Diabetes
Albrechtsen, N. J. W., Pedersen, J., Galsgaard, K. D., Winther‐Sørensen, M., Suppli, M. P., Janah, L., Gromada, J., Vilstrup, H., Knop, F. K., & Holst, J. J. (2019) · Endocrine Reviews · doi:10.1210/er.2018-00251 · Cited by 149 · see citing works
Winther-Sørensen, M., Galsgaard, K. D., Santos, A., Trammell, S. A. J., Sulek, K., Kuhre, R. E., Pedersen, J., Andersen, D. B., Hassing, A. S., Dall, M., et al. (2020) · Molecular Metabolism · doi:10.1016/j.molmet.2020.101080 · Cited by 135 · see citing works
Wewer Albrechtsen, N. J., Færch, K., Jensen, T. M., Witte, D. R., Pedersen, J., Mahendran, Y., Jonsson, A. E., Galsgaard, K. D., Winther-Sørensen, M., Torekov, S. S., et al. (2018) · Diabetologia · doi:10.1007/s00125-017-4535-5 · Cited by 119 · see citing works
Insulin resistance and reduced metabolic flexibility: cause or consequence of NAFLD?
Gastaldelli, A. (2017) · Clinical Science · doi:10.1042/cs20170987 · Cited by 95 · see citing works
Houttu, V., Csader, S., Nieuwdorp, M., Holleboom, A. G., & Schwab, U. (2021) · Frontiers in Nutrition · doi:10.3389/fnut.2021.716783 · Cited by 95 · see citing works
Recent research trends and updates on nonalcoholic fatty liver disease
Yoo, J., Kim, W. K., Kim, M. Y., Jun, D. W., Kim, S. G., Yeon, J.-E., Lee, J. W., Cho, Y. K., Park, S. H., & Sohn, J. H. (2018) · Clinical and Molecular Hepatology · doi:10.3350/cmh.2018.0037 · Cited by 92 · see citing works
González‐González, J. G., Violante-Cumpa, J. R., Zambrano-Lucio, M., Burciaga-Jimenez, E., Morales, P., García-Campa, M., Solís, R. C., González-Colmenero, A. D., & Rodríguez‐Gutiérrez, R. (2022) · High Blood Pressure & Cardiovascular Prevention · doi:10.1007/s40292-022-00542-5 · Cited by 86 · see citing works
Nachit, M., De Rudder, M., Thissen, J., Schakman, O., Bouzin, C., Horsmans, Y., Vande Velde, G., & Leclercq, I. A. (2021) · Journal of Cachexia, Sarcopenia and Muscle · doi:10.1002/jcsm.12646 · Cited by 82 · see citing works
A critical review of endpoints for non-cirrhotic NASH therapeutic trials
Ratziu, V. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2017.12.001 · Cited by 74 · see citing works
Li, Y., & Su, Y. (2020) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2020.03.034 · Cited by 61 · see citing works
Colantoni, A., Bucci, T., Cocomello, N., Angelico, F., Ettorre, E., Pastori, D., Lip, G. Y. H., Ben, M. D., & Baratta, F. (2024) · Cardiovascular Diabetology · doi:10.1186/s12933-024-02263-6 · Cited by 64 · see citing works
Castellino, G., Nikolić, D., Magán‐Fernández, A., Malfa, G. A., Chianetta, R., Patti, A. M., Amato, A., Montalto, G., Toth, P. P., Banach, M., et al. (2019) · Nutrients · doi:10.3390/nu11112580 · Cited by 61 · see citing works
Pediatric Non-Alcoholic Fatty Liver Disease: Nutritional Origins and Potential Molecular Mechanisms
Mandala, A., Janssen, R., Palle, S. K., Short, K., & Friedman, J. (2020) · Nutrients · doi:10.3390/nu12103166 · Cited by 51 · see citing works
Li, Y., Zheng, R., Li, J., Feng, S., Wang, L., & Huang, Z. (2020) · Lipids in Health and Disease · doi:10.1186/s12944-020-01409-1 · Cited by 56 · see citing works
Lee, J., Park, K., Lee, H. S., Park, H.-K., Han, J. H., & Ahn, S. B. (2022) · Clinical and Molecular Hepatology · doi:10.3350/cmh.2022.0099 · Cited by 54 · see citing works
Chen, C., Zhang, C., Wang, X., Zhang, F., Zhang, Z., Ma, P., & Feng, S. (2019) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000001601 · Cited by 47 · see citing works
Gaggini, M., Carli, F., Rosso, C., Younes, R., D’Aurizio, R., Bugianesi, E., & Gastaldelli, A. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20246333 · Cited by 43 · see citing works
Ruissen, M. M., Mak, A. L., Beuers, U. H., Tushuizen, M. E., & Holleboom, A. G. (2020) · European Journal of Endocrinology · doi:10.1530/eje-20-0065 · Cited by 44 · see citing works
The Role of Hepatic Fat Accumulation in Glucose and Insulin Homeostasis—Dysregulation by the Liver
London, A., Lundsgaard, A., Kiens, B., & Bojsen-Møller, K. N. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10030390 · Cited by 44 · see citing works
The PNPLA3-I148M Variant Confers an Antiatherogenic Lipid Profile in Insulin-resistant Patients
Luukkonen, P. K., Qadri, S. U., Lehtimäki, T. E., Juuti, A., Sammalkorpi, H. E., Penttilä, A. K., Hakkarainen, A., Orho‐Melander, M., Arola, J. T., & Yki‐Järvinen, H. (2020) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa729 · Cited by 42 · see citing works
Sun, H., Chang, X., Bian, N., An, Y., Liu, J., Leng, S., & Wang, G. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.835154 · Cited by 38 · see citing works
Ahmad, M. I., Zou, X., Ijaz, M. U., Hussain, M., Liu, C., Xu, X., Zhou, G., & Li, C. (2019) · Journal of Agricultural and Food Chemistry · doi:10.1021/acs.jafc.9b03136 · Cited by 37 · see citing works
Yoon, J. S., Shim, Y. S., Lee, H. S., Hwang, I. T., & Hwang, J. S. (2021) · Scientific Reports · doi:10.1038/s41598-021-03138-6 · Cited by 37 · see citing works
Mei, Y., Li, A., Zhao, J., Zhou, Q., Zhao, M., Xu, J., Li, R., Li, Y., Li, K., Ge, X., et al. (2022) · Environmental Research · doi:10.1016/j.envres.2022.114472 · Cited by 36 · see citing works
Kim, H. S., Cho, Y. K., Kim, E. H., Lee, M. J., Jung, C. H., Park, J., Kim, H., & Lee, W. J. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm11010041 · Cited by 35 · see citing works
Li, A., Mei, Y., Zhao, M., Xu, J., Seery, S., Li, R., Zhao, J., Zhou, Q., Ge, X., & Xu, Q. (2020) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2020.143308 · Cited by 34 · see citing works
Association between TyG index trajectory and new-onset lean NAFLD: a longitudinal study
Liu, H., Chen, J., Qin, Q., Su, Y., Wang, Y., Li, J., & Ding, S. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1321922 · Cited by 33 · see citing works
Somatotropic Axis and Obesity: Is There Any Role for the Mediterranean Diet?
Muscogiuri, G., Barrea, L., Laudisio, D., Somma, C. D., Pugliese, G., Salzano, C., Colao, A., & Savastano, S. (2019) · Nutrients · doi:10.3390/nu11092228 · Cited by 30 · see citing works
Association between dietary sodium intake and non-alcoholic fatty liver disease in the US population
Zhou, L., Yang, Y., Feng, Y., Zhao, X., Fan, Y., Rong, J., Zhao, L., & Yu, Y. (2020) · Public Health Nutrition · doi:10.1017/s136898001900483x · Cited by 31 · see citing works
Chen, Y., Lü, C., Ju, H., Zhou, Q., & Zhao, X. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1405828 · Cited by 29 · see citing works
Mora‐Rodríguez, R., ORTEGA, J. F., Ramírez-Jiménez, M., Moreno‐Cabañas, A., & Morales‐Palomo, F. (2019) · Diabetes & Metabolism · doi:10.1016/j.diabet.2019.05.004 · Cited by 29 · see citing works
Wu, L., Liu, Y., Zhao, Y., Li, M., & Guo, L. C. (2020) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2020.04.009 · Cited by 27 · see citing works
HOMA-IR is an effective biomarker of non-alcoholic fatty liver disease in non-diabetic population
Zeng, P., Cai, X., Yu, X., Huang, L., & Chen, X. (2023) · Journal of International Medical Research · doi:10.1177/03000605231204462 · Cited by 26 · see citing works
Diagnostic performance of sixteen biomarkers for MASLD: A study in a Mexican cohort
Priego-Parra, B. A., Reyes-Diaz, S. A., Alvarez, H. R. O., Bernal-Reyes, R., Icaza-Chávez, M. E., Vázquez, S., Amieva‐Balmori, M., Vivanco-Cid, H., Velasco, J. A. V.-R., Gracia‐Sancho, J., et al. (2024) · Clinics and Research in Hepatology and Gastroenterology · doi:10.1016/j.clinre.2024.102400 · Cited by 25 · see citing works
Coccia, F., Testa, M., Guarisco, G., Cristofano, C. D., Silecchia, G., Leonetti, F., Gastaldelli, A., & Capoccia, D. (2019) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2019.08.001 · Cited by 25 · see citing works
Katsiki, N., Gastaldelli, A., & Mikhailidis, D. P. (2019) · Metabolism · doi:10.1016/j.metabol.2019.154010 · Cited by 26 · see citing works
Dietary habits associated with reduced insulin resistance: The Nagahama study
Ikeda, K., Sato, T. S., Nakayama, T., Tanaka, D., Nagashima, K., Mano-Usui, F., Joo, E., Fujimoto, S., Takahashi, Y., Kosugi, S., et al. (2018) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2018.04.006 · Cited by 26 · see citing works
Chen, J. Y. S., Chua, D., Lim, C. O., Ho, W. X., & Tan, N. S. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms24010158 · Cited by 23 · see citing works
Prevalence of Insulin Resistance in Adults Living with HIV: Implications of Alcohol Use
Simon, L., Ferguson, T. F., Stouwe, C. V., Brashear, M. M., Primeaux, S. D., Theall, K. P., Welsh, D. A., & Molina, P. E. (2020) · AIDS Research and Human Retroviruses · doi:10.1089/aid.2020.0029 · Cited by 21 · see citing works
Wajcman, D. I., Zelber‐Sagi, S., Isakov, N. F., Webb, M., Zemel, M., Shibolet, O., & Kariv, R. (2019) · Clinical and Translational Gastroenterology · doi:10.14309/ctg.0000000000000040 · Cited by 20 · see citing works
Kim, K., Hong, S., Ahn, H. Y., & Park, C. (2022) · Obesity · doi:10.1002/oby.23438 · Cited by 20 · see citing works
PNPLA3 rs738409 risk genotype decouples TyG index from HOMA2-IR and intrahepatic lipid content
Nádasdi, Á., Gál, V., Masszi, T., Somogyi, A., & Firneisz, G. (2023) · Cardiovascular Diabetology · doi:10.1186/s12933-023-01792-w · Cited by 20 · see citing works
Sogabe, M., Okahisa, T., Kurihara, T., Takehara, M., Kagemoto, K., Okazaki, J., Kida, Y., Hirao, A., Tanaka, H., Tomonari, T., et al. (2020) · PLoS ONE · doi:10.1371/journal.pone.0238388 · Cited by 20 · see citing works
Noninvasive assessment of hepatic steatosis and fibrosis in patients with severe obesity
Coccia, F., Testa, M., Guarisco, G., Bonci, E., Cristofano, C. D., Silecchia, G., Leonetti, F., Gastaldelli, A., & Capoccia, D. (2019) · Endocrine · doi:10.1007/s12020-019-02155-w · Cited by 17 · see citing works
Intact Fasting Insulin Identifies Nonalcoholic Fatty Liver Disease in Patients Without Diabetes
Bril, F., McPhaul, M. J., Kalavalapalli, S., Lomonaco, R., Barb, D., Gray, M. E., Shiffman, D., Rowland, C. M., & Cusi, K. J. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab417 · Cited by 17 · see citing works
Simon, L., Torres, D., Saravia, A., Levitt, D. E., Stouwe, C. V., McGarrah, H., Coleman, L., Dufour, J., Amedee, A. M., & Molina, P. E. (2021) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00159.2021 · Cited by 17 · see citing works
Mechanisms for increased risk of diabetes in chronic liver diseases
Svegliati‐Baroni, G., Gaggini, M., Carli, F., Barbieri, C., Cucco, M., Younes, R., Rosso, C., Bugianesi, E., & Gastaldelli, A. (2020) · Liver International · doi:10.1111/liv.14556 · Cited by 17 · see citing works
van Son, K. C., Verschuren, L., Hanemaaijer, R., Reeves, H. L., Takkenberg, R. B., Drenth, J. P. H., Tushuizen, M. E., & Holleboom, A. G. (2023) · Cancers · doi:10.3390/cancers15041308 · Cited by 15 · see citing works
Chen, Y., & Zhao, X. (2024) · Immunity Inflammation and Disease · doi:10.1002/iid3.70035 · Cited by 15 · see citing works
Bae, S. M., Fan, M., Choi, Y., Tang, Y., Jeong, G., Myung, K., Kim, B., & Kim, E. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21228537 · Cited by 17 · see citing works
Zyśk, B., Ostrowska, L., Smarkusz-Zarzecka, J., Orywal, K., Mroczko, B., & Cwalina, U. (2024) · Nutrients · doi:10.3390/nu16091381 · Cited by 14 · see citing works
Danford, C. J., Connelly, M. A., SHALAUROVA, I. Y., Kim, M.-S., Herman, M. A., Nasser, I. A., Otvos, J. D., Afdhal, N. H., Jiang, Z. G., & Lai, M. (2018) · Hepatology Communications · doi:10.1002/hep4.1267 · Cited by 13 · see citing works
Eshraghian, A., Nikeghbalian, S., Shamsaeefar, A., Kazemi, K., Fattahi, M. R., & Malek‐Hosseini, S. A. (2020) · Scientific Reports · doi:10.1038/s41598-020-69571-1 · Cited by 13 · see citing works
Primeaux, S. D., Simon, L., Ferguson, T. F., Levitt, D. E., Brashear, M. M., Yeh, A. Y., & Molina, P. E. (2021) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.14667 · Cited by 12 · see citing works
Ponirakis, G., Abdul‐Ghani, M. A., Jayyousi, A., Zirie, M. A., Al‐Mohannadi, S., Almuhannadi, H., Petropoulos, I. N., Khan, A., Gad, H., Migahid, O., et al. (2021) · Journal of Diabetes Investigation · doi:10.1111/jdi.13582 · Cited by 11 · see citing works
Zhou, M., & Huang, R. (2022) · Nutrients · doi:10.3390/nu14173526 · Cited by 12 · see citing works
Ability of soluble TREM2 and PRO-C3 as biomarkers to predict changes in MASLD activity
Wernberg, C. W., Chandran, V. I., Lauridsen, M. M., Skytthe, M. K., Hansen, C. D., Hansen, J. K., Grønkjær, L. L., Jacobsen, B. G., Caterino, T. D., Detlefsen, S., et al. (2025) · JHEP Reports · doi:10.1016/j.jhepr.2025.101432 · Cited by 11 · see citing works
Extracellular Vesicles in Pathogenesis and Treatment of Metabolic Associated Fatty Liver Disease
Sun, J., Zhang, D., & Li, Y. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.909518 · Cited by 11 · see citing works
HOMA-IR mean values in healthy individuals: a population-based study in iranian subjects
Masoodian, S. M., Omidifar, A., Moradkhani, S., Asiabanha, M., & Khoshmirsafa, M. (2022) · Journal of Diabetes & Metabolic Disorders · doi:10.1007/s40200-022-01099-9 · Cited by 11 · see citing works
Tang, X., Wu, R., Chen, J., Wang, F.-L., Zhao, S.-L., Lu, J. L., Qin, J., Zhuang, D., & Zhang, B. (2025) · Metabolism Open · doi:10.1016/j.metop.2025.100402 · Cited by 10 · see citing works
The color of fat and its central role in the development and progression of metabolic diseases
Gaggini, M., Carli, F., & Gastaldelli, A. (2017) · Hormone Molecular Biology and Clinical Investigation · doi:10.1515/hmbci-2017-0060 · Cited by 10 · see citing works
HOMA-IR index in non-diabetic patient, a reliable method for early diagnosis of liver steatosis.
Motamed, B., Vajargah, M. K., Kalantari, S., & Shafaghi, A. (2022) · PubMed Central · doi:10.22088/cjim.13.3.519 · Cited by 10 · see citing works
Non-invasive diagnosis of nonalcoholic fatty liver disease: impact of age and other risk factors
Bayrak, M. (2020) · The Aging Male · doi:10.1080/13685538.2020.1763293 · Cited by 9 · see citing works
Leveraging the future of diagnosis and management of diabetes: From old indexes to new technologies
Meneses, M. J., Patarrão, R. S., Pinheiro, T., Coelho, I., Carriço, N., Marques, A. C., Romão, A., Nabais, J. M. V., Fortunato, E. M. C., Raposo, J. F., et al. (2022) · European Journal of Clinical Investigation · doi:10.1111/eci.13934 · Cited by 9 · see citing works
Alshehade, S. A., Zarzour, R. H. A., Mathai, M. L., Giribabu, N., Seyedan, A., Kaur, G., Al‐Suede, F. S. R., Majid, A. M. S. A., Murugaiyah, V., Almoustafa, H. A., et al. (2023) · Pharmaceuticals · doi:10.3390/ph16010109 · Cited by 9 · see citing works
Kim, M., Ahn, S., Hur, N., Oh, S.-Y., & Son, C. (2024) · Frontiers in Pharmacology · doi:10.3389/fphar.2024.1362391 · Cited by 8 · see citing works
Zhang, L., He, Y., Wu, C., Wu, M., Chen, X., Luo, J. M., Cai, Y., Xia, P., & Chen, B. (2019) · International Journal of Molecular Medicine · doi:10.3892/ijmm.2019.4313 · Cited by 8 · see citing works
Amirkhizi, F., Taghizadeh, M., Khalese-Ranjbar, B., Shahraki, S. H., & Asghari, S. (2025) · BMC Gastroenterology · doi:10.1186/s12876-025-03613-8 · Cited by 7 · see citing works
Xin, Z., Feng, L., Yu, Q., Shi, Y., Tang, T., Tong, X., Hu, S., You, Y., Zhang, S., Zhang, X., et al. (2025) · BMC Gastroenterology · doi:10.1186/s12876-025-03888-x · Cited by 7 · see citing works
Insulin Resistance Markers to Detect Nonalcoholic Fatty Liver Disease in a Male Hispanic Population
Pérez-Mayorga, M., López-López, J., Chacón-Manosalva, M. A., Castillo, M. G., Otero, J. A., Martínez-Bello, D., Gómez-Arbeláez, D., Cohen, D. D., & López-Jaramillo, P. A. (2022) · Canadian Journal of Gastroenterology and Hepatology · doi:10.1155/2022/1782221 · Cited by 7 · see citing works
Shih, Y.-L., Huang, T.-C., Shih, C.-C., & Chen, J. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11185357 · Cited by 7 · see citing works
Circulating BCKAs are closely associated with adipose tissue insulin resistance in type 2 diabetes
Gao, J., Rouzi, M. R. Y., Yang, H., Zheng, W., Wang, L., Lei, T., & Lu, J. K. (2025) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-025-01860-z · Cited by 5 · see citing works
Kim, I., Lee, K., Sung, J., Ahn, Y. J., Im, M., Han, K., & Cho, S. Y. (2025) · Annals of Pediatric Endocrinology & Metabolism · doi:10.6065/apem.2448180.090 · Cited by 5 · see citing works
Bade, N., Hellman, D. A., Matye, D. J., Jiang, S., Tryggestad, J. B., Yu, Z., Short, K. R., & Palle, S. K. (2025) · Journal of Cellular and Molecular Medicine · doi:10.1111/jcmm.70817 · Cited by 4 · see citing works
Noh, E.-S., & Hwang, I. T. (2024) · Medicine · doi:10.1097/md.0000000000038241 · Cited by 4 · see citing works
NAFLD and Insulin Resistance: A Multisystemic Disease
Gastaldelli, A. (2020) · Springer eBooks · doi:10.1007/978-3-319-95828-6_4 · Cited by 4 · see citing works
Physical activity, fitness, and cardiac autonomic function among adults born postterm
Oksanen, P., Tikanmäki, M., Tulppo, M. P., Niemelä, M., Korpelainen, R., & Kajantie, E. (2024) · American Journal of Epidemiology · doi:10.1093/aje/kwae150 · Cited by 3 · see citing works
Emir, S. N., & Emir, S. (2024) · Turkish Journal of Diabetes and Obesity · doi:10.25048/tudod.1461623 · Cited by 3 · see citing works
Insulin Resistance after Fontan Palliation
Shea, E. V., Yu, S., Schumacher, K. R., Lowery, R., Doman, T., & Rocchini, A. P. (2024) · Pediatric Cardiology · doi:10.1007/s00246-024-03663-x · Cited by 3 · see citing works
Visaria, A., Kanaya, A. M., Setoguchi, S., Gadgil, M. D., & Satagopan, J. M. (2024) · PLoS ONE · doi:10.1371/journal.pone.0297685 · Cited by 3 · see citing works
Sotorník, R., Suissa, R., & Ardilouze, J. (2022) · Clinical Diabetes · doi:10.2337/cd21-0044 · Cited by 3 · see citing works
BARRETO, B. F. D. M., Punaro, G., ELIAS, M. C., & Parise, E. R. (2022) · Arquivos de Gastroenterologia · doi:10.1590/s0004-2803.202203000-72 · Cited by 2 · see citing works
Karaagac, D., Morkuzu, S., Şenkal, N., Bilgin, E., Oyacı, Y., Tükek, T., Pehlıvan, S., & Medetalibeyoglu, A. (2025) · Medicina · doi:10.3390/medicina61081479 · Cited by 1 · see citing works
Cao, Q., Tian, Q., Liu, Y., Cheng, Y., Luo, T., & Zhu, X. (2025) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s568870 · Cited by 1 · see citing works
Monneret, D., & Bonnefont‐Rousselot, D. (2020) · European Journal of Gastroenterology & Hepatology · doi:10.1097/meg.0000000000001626
Хухліна, О. С., & Kotsiubiichuk, Z. Y. (2020) · Bukovinian Medical Herald · doi:10.24061/2413-0737.xxiv.3.95.2020.84
Combined Effects of Insulin Resistance and Inflammation on Comorbidities of Type 2 Diabetes
Kim, E. J., Lee, E. Y., Lee, Y., Choi, Y. J., Park, S. W., Lee, E. J., Lee, H. C., & Huh, K. B. (2021) · Journal of Korean Diabetes · doi:10.4093/jkd.2021.22.3.207
Jamal, O., Kasmy, Z., Chala, S., Sekkach, Y., & Ennibi, K. (2021) · Nutrition Clinique et Métabolisme · doi:10.1016/j.nupar.2021.07.001
Yoon, J. S., Shim, Y. S., Lee, H. S., Hwang, I. T., & Hwang, J. S. (2021) · Research Square · doi:10.21203/rs.3.rs-721138/v1
Stepanov, Y. М., Zavhorodnia, N. Y., Tatarchuk, О. М., Кленіна, І. А., & Петішко, О. П. (2023) · CHILD`S HEALTH · doi:10.22141/2224-0551.17.7.2022.1536
- Authors
- Isokuortti, E., Zhou, Y., Peltonen, M., Bugianesi, E., Clement, K., Bonnefont-Rousselot, D., Lacorte, J.-M., Gastaldelli, A., Schuppan, D., Schattenberg, J. M., Hakkarainen, A., Lundbom, N., Jousilahti, P., Männistö, S., Keinänen-Kiukaanniemi, S., Saltevo, J., Anstee, Q. M., & Yki-Järvinen, H.
- Affiliations
- University of Helsinki (FI)
- Cardiff University (GB)
- Finnish Institute for Health and Welfare (FI)
- University of Turin (IT)
- Inserm (FR)
- Istituto di Fisiologia Clinica (IT)
- Johannes Gutenberg University Mainz (DE)
- Central Finland Health Care District (FI)
- Freeman Hospital (GB)
- Corresponding author
- Isokuortti, Elina
- ORCID
- Venue
- Diabetologia
- Published
- 2017-06-29
- Volume
- 60
- Issue
- 10
- Pages
- 1873-1882
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2728177312
- Cited by
- 120
- References
- 49
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 20 · 2023: 9 · 2022: 18 · 2021: 12 · 2020: 20 · 2019: 14 · 2018: 6 · 2017: 3
- FWCI
- 9.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
- HAL (submittedVersion)
- Työväentutkimus Vuosikirja (submittedVersion, other-oa)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- The Novo Nordisk Foundation
- Suomen Akatemia
- Paulon Säätiö
- Horizon 2020 Framework Programme (Grant Agreement 634413)
- The Sigrid Juselius Foundation
- Suomen Lääketieteen Säätiö
- EU/EFPIA Innovative Medicines Initiative Joint Undertaking (EMIF grant no. 115372)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- non-alcoholic fatty liver disease, HOMA-IR, insulin resistance, reference values, upper limit of normal, diagnostic thresholds, PNPLA3 rs738409, sex differences, inter-laboratory variability, liver fat, 1H NMR, type 2 diabetes prevention
- MeSH terms
- Blood Glucose, Female, Humans, Insulin, Insulin Resistance, Liver, Male, Middle Aged, Reference Values, Adiposity, Young Adult, Antibodies, Monoclonal, Humanized, Non-alcoholic Fatty Liver Disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
